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    广州市学龄儿童农药暴露水平与超重和肥胖的关联

    Association of pesticide exposure with overweight and obesity among school-aged children in Guangzhou, China

      摘要
    • 摘要:
      目的 探讨儿童尿中农药代谢物水平及其与超重/肥胖的关联。
      方法 采用横断面研究，以2022年1 969名广州市学龄儿童为研究对象。使用超高效液相色谱-三重四极杆质谱法检测尿液中农药代谢物的浓度。按照《学龄儿童青少年超重与肥胖筛查》(WS/T 586-2018) 判断儿童是否超重或肥胖。使用二元Logistic回归和限制性立方样条(restricted cubic spline, RCS) 模型分析儿童单一尿农药代谢物浓度与超重/肥胖的关联，使用加权分位数和(weighted quantile sum, WQS) 回归和分位数g计算(quantile g-computation, qgcomp) 回归评估农药混合暴露对超重/肥胖发生风险的总体效应。按性别进行分层和交互作用分析。
      结果 在1 969名儿童中，超重率为17.78%，肥胖率为10.77%。调整混杂因素后，二元Logistic回归模型显示，尿3-苯氧基苯甲酸(3-phenoxybenzoic acid，3-PBA)、顺式二氯乙烯基二甲基环丙烷羧酸cis-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid，cis-DCCA和反式二氯乙烯基二甲基环丙烷羧酸trans-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid，trans-DCCA的水平与儿童超重/肥胖存在正向关联，比值比(odds ratio，OR) 和95%置信区间(confidential interval，CI) 分别为1.13 (1.03，1.23)、1.09 (1.01，1.17)、1.10 (1.02，1.19)。RCS分析结果表明，尿trans-DCCA水平与超重/肥胖之间存在非线性剂量-反应关系(P总体=0.003, P非线性=0.028)。WQS和qgcomp模型显示，6种农药混合暴露对儿童超重/肥胖发生风险的影响无统计学意义(P>0.05)。分层分析结果显示，女童尿3-PBA、cis-DCCA和trans-DCCA的水平与超重/肥胖的风险存在正向关联(P < 0.05)，但在男童中两者的关联无统计学意义。
      结论 尿3-PBA、cis-DCCA和trans-DCCA水平与儿童超重/肥胖风险存在正向关联，提示拟除虫菊酯类农药暴露可能会增加儿童超重/肥胖的风险。

       

      Abstract:
      Objective To investigate the levels of urinary pesticide metabolites and their association with overweight and obesity in children.
      Methods A cross-sectional study was conducted on 1969 school-aged children in Guangzhou, China, in 2022. Ultra-high-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UHPLC-MS/MS) was used to measure the concentrations of pesticide metabolites in urine. According to the Screening for Overweight and Obesity among School-age Children and Adolescents (WS/T 586-2018), the children were divided into two groups, namely normal and overweight/obesity. The relationship between the concentrations of urinary pesticide metabolites and overweight/obesity in children was evaluated using binary logistic regression and restricted cubic spline (RCS) models. Weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) regression models were used to assess the overall effects of pesticide mixture exposure on overweight/obesity. Stratified and interaction analyses were conducted by sex.
      Results The proportions of overweight and obesity were 17.78% and 10.77%, respectively, among 1 969 children. After adjusting for confounding factors, binary logistic regression models showed that urinary levels of 3-phenoxybenzoic acid (3-PBA), cis-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid (cis-DCCA), and trans-3-(2, 2-dichlorovinyl)-2, 2-dimethylcyclopropane-1-carboxylic acid (trans-DCCA) were positively correlated with overweight/obesity in children, with corresponding odds ratios (OR) and 95% confidence intervals (CI) being 1.13 (1.03, 1.23), 1.09 (1.01, 1.17), and 1.10 (1.02, 1.19), respectively. The results of RCS analyses revealed a non-linear dose-response relationship between urinary trans-DCCA level and overweight/obesity (Poverall=0.003, Pnonlinear=0.028). The WQS and qgcomp models revealed that there were no significant effects of six-pesticide mixture exposure on the risk of overweight/obesity in children (P>0.05). Stratified analysis showed that there was a significantly positive correlation of the concentrations of 3-PBA, cis-DCCA, and trans-DCCA with the risk of overweight/obesity in girls (P < 0.05) but not in boys.
      Conclusion The urinary levels of 3-PBA, cis-DCCA, and trans-DCCA are positively correlated with the risk of overweight/obesity in children, suggesting that exposure to pyrethroid pesticides may increase the risk of overweight/obesity in children.

       

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